Podcast #102: Inotropes

Inotropes are used for cardiogenic shock patients, specifically when volume status is elevated and the cardiac output is low.

Dobutamine acts on beta-1 and beta-2 adrenergic receptors, increasing contractility and blood pressure. It also causes vasodilation – for patients with a systolic blood pressure less than 80 caution is advised. It could be beneficial to have levophed hanging in the case of a hypotensive episode.

Milrinone is a phosphodiesterase-3 inhibitor that blocks breakdown of cyclic AMP.

Dobutamine has a half life of minutes, whereas milrinone has a half life of hours.